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Marine microplastic concentration and associations with stroke and chronic disease prevalence
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  • Open access
  • Published: 16 May 2026

Marine microplastic concentration and associations with stroke and chronic disease prevalence

  • Sai Rahul Ponnana1,
  • El-Hussain Shamsa2,3,
  • Zhuo Chen1,
  • Tejas Rajagopalan4,
  • Tong Zhang1,
  • Santosh Sirasapalli1,
  • Skanda Moorthy1,
  • Jean-Eudes Dazard1,
  • Sadeer Al-Kindi5 &
  • …
  • Salil V. Deo1,6 

npj Cardiovascular Health (2026) Cite this article

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Subjects

  • Cardiology
  • Cardiovascular diseases

Abstract

Microplastics (MPs), synthetic polymer particles <5 mm, are emerging environmental contaminants with potential cardiometabolic relevance. We conducted a cross-sectional analysis of 709 coastal census tracts ( < 200 meters from shoreline) by linking NOAA marine microplastic measurements with chronic disease prevalence estimates from the CDC PLACES database. A total of 154 demographic, socioeconomic, and environmental variables including age, sex, race, median household income, Social Vulnerability Index, insurance coverage, and PM2.5 were incorporated to adjust for confounding. Adjusted Poisson regression models showed that tracts with the highest microplastic exposure had higher prevalence of stroke (PR = 1.21, 95% CI: 1.13–1.29), diabetes (PR = 1.17, 95% CI: 1.10–1.24), and hypertension (PR = 1.10, 95% CI: 1.06–1.14) compared with low-exposure areas. Among all covariates, XGBoost models with SHAP interpretation identified microplastic concentration as an important environmental predictor of stroke prevalence. These ecological findings suggest microplastics were associated with chronic disease patterns and warrant further investigation.

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Acknowledgements

We acknowledge the support of the Cardiovascular Research Institute at Case Western Reserve University and University Hospitals for providing computational and analytic resources. No specific funding was received for this study.

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Authors and Affiliations

  1. Case School of Medicine, Case Western Reserve University, Cleveland, OH, USA

    Sai Rahul Ponnana, Zhuo Chen, Tong Zhang, Santosh Sirasapalli, Skanda Moorthy, Jean-Eudes Dazard & Salil V. Deo

  2. Department of Medicine, University Hospitals, Cleveland, OH, USA

    El-Hussain Shamsa

  3. Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, USA

    El-Hussain Shamsa

  4. University Schools, Cleveland, OH, USA

    Tejas Rajagopalan

  5. Division of Cardiology, Houston Methodist Hospital, Houston, OH, USA

    Sadeer Al-Kindi

  6. Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA

    Salil V. Deo

Authors
  1. Sai Rahul Ponnana
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  2. El-Hussain Shamsa
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  4. Tejas Rajagopalan
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  6. Santosh Sirasapalli
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  7. Skanda Moorthy
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  8. Jean-Eudes Dazard
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  9. Sadeer Al-Kindi
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  10. Salil V. Deo
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Corresponding author

Correspondence to Salil V. Deo.

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Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

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Cite this article

Ponnana, S.R., Shamsa, EH., Chen, Z. et al. Marine microplastic concentration and associations with stroke and chronic disease prevalence. npj Cardiovasc Health (2026). https://doi.org/10.1038/s44325-026-00133-6

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  • Received: 12 June 2025

  • Accepted: 08 May 2026

  • Published: 16 May 2026

  • DOI: https://doi.org/10.1038/s44325-026-00133-6

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